Cannabis has long been a polarizing topic in the medical community, but 2023 marked a pivotal moment for its integration into health care. That September, the American Nurses Association (ANA) — an organization representing more than 5 million nurses nationwide — officially recognized Cannabis nursing as a specialty. Less than a year later, in June 2024, the ANA and the American Cannabis Nurses Association (ACNA) jointly published “Cannabis Nursing: Scope and Standards of Practice,” solidifying the role of Cannabis nurses in the broader health care system.
“This is huge,” said Dr. Deanna Sommers, PhD, RN, CPNP, incoming ACNA president-elect for 2025 and one of the lead authors of the publication. “If you look at other specialties, they all have a scope and standards. Now we finally do too.”
The publication addresses the unique challenges nurses face in providing safe and ethical care for patients using Cannabis. From educating patients about its potential benefits and risks to navigating the complexities of federal and state laws, Cannabis nursing aims to bridge a critical gap in modern health care.
A New Frontier
Nursing is often described as the backbone of health care, with nurses consistently ranking among the most trusted professionals. Cannabis, however, has long existed in a legal and cultural gray area, creating serious challenges for both nurses and patients.
“Nurses are the most trusted organization through and through, and most people don’t go to their physician and say, ‘Hey, I was thinking about trying Cannabis,’” said Nicole Foss, MBA, RN and current president of the ACNA, during our conversation. “No, they’re going to talk to the nurse.” That means, whether they like it or not, nurses are already on the front lines of guiding Cannabis-using patients. The ACNA’s new specialty scope and standards give them the tools to do it responsibly.
So, what is a Cannabis nurse? Cannabis nursing is officially defined as a specialty practice focused on the care of health care consumers seeking education and guidance in the therapeutic use of Cannabis. This encompasses everything from discussing Cannabis’s potential benefits and risks to ensuring its safe integration with other medications.
Founded in 2006 by visionary leaders late nurse Julia (Ed) Glick and Mary Lynn Mathre during the Fourth National Clinical Conference on Cannabis Therapeutics (presented by Patients Out of Time), the ACNA began as a collective of passionate nurses working with medical Cannabis patients when it was still deeply stigmatized. According to Foss, the group’s earliest efforts centered on “helping patients figure out how to navigate Cannabis when it was very, very taboo,” but it soon evolved to address bigger hurdles, such as outdated school policies, inconsistent regulations and a lack of formal education in nursing curricula.
From Taboo to Textbook
With education at the head of their mission, the ACNA stepped in to begin formal education. After three years in the making, “Cannabis Nursing: Scope and Standards of Practice” was published.
The publication outlines 18 standards, divided between the traditional nursing process (assessment, diagnosis, outcomes, planning, implementation and evaluation) and professional performance (ethics, collaboration, research, education and more).
While drafting the document, Dr. Sommers and her colleagues faced significant obstacles, including federal laws that still classify Cannabis as a Schedule I drug. “Nursing curricula still barely mention Cannabis, other than substance abuse,” Dr. Sommers noted. “The federal ban doesn’t help. But we’ve got to align with reality: patients are using Cannabis every day.”
Bridging the Gap
Many nursing programs simply do not address Cannabis’s potential therapeutic applications, focusing instead on substance-abuse concerns. Dr. Sommers points out that this creates a significant knowledge gap at the point of care, especially as more states legalize Cannabis for medical or adult use.
According to Foss, the ACNA hopes the new scope and standards will serve as a jumping-off point for curriculum development. “We need to empower nurses so they can empower patients,” she said. “That starts with education.”
Ethical Challenges
The new scope and standards also highlight the ethical and educational complexities nurses often face. “We had a nursing student who tested positive for Cannabis three months before graduating,” Dr. Sommers recalled. “Four years of nursing school — gone. That just didn’t feel right to me, so I started digging deeper.”
Her inquiries led to the realization that many nursing schools operate under zero-tolerance policies that make little sense in states where adult-use Cannabis is legal. Dr. Sommers revised her own program’s policy to allow one retest, but the student’s sample came back “negative, dilute,” which certain clinical agencies still treated as a positive. “That heartbreak — and others like it — was a major motivation to get involved with ACNA,” she said.
Foss, who has a well-rounded background working closely with veterans as well as Cannabis companies, sees firsthand the impact of legal inconsistencies. “Insurance is a hard game, but we’re at a tipping point,” she told me. “Some plans are finally ready to put CBD products on their portals. That’s taken three years of conversations just for one insurer.”
Certification Ahead
With the new scope and standards published, the big question is: What comes next? For the ACNA, it’s about formalizing an exam that would allow nurses to achieve board certification in Cannabis nursing.
“People ask, ‘When can I take the test?’” Dr. Sommers said, laughing. “Well, we have to pilot and validate questions. Different states, different laws. It’s a process, but it’ll legitimize Cannabis nursing even more.”
Policy Shift
Meanwhile, ACNA is pushing for change at the legislative level. The organization is collaborating with the ANA on policy discussions surrounding re-scheduling or de-scheduling Cannabis, effectively making it more accessible to patients without stigmatizing nurses. “Ultimately, ACNA wants Cannabis de-scheduled,” Dr. Sommers said. “We can’t just wait for regulators to catch up.”
Foss, who also has a background in insurance, emphasized that insurance reimbursement for Cannabis-based therapies could be on the horizon. “Nurses are in a perfect position to drive that conversation,” she said. “Whether it’s legislative or insurance-based, we want consistent, safe access for patients.”
Personal Journeys
Perhaps most striking are the stories of personal transformation. Dr. Sommers went from being “fearful” and “anti-Cannabis” to a staunch defender of patients’ rights. Foss relayed how a pharmacology professor once told her that, if she had ever used Cannabis, she would be unwelcome in the profession. Today, she is leading a national association dedicated to Cannabis nursing.
“I think all nurses are Cannabis nurses; they just don’t recognize it,” Dr. Sommers said. “We assess patients’ meds every day. Cannabis is just another piece of that puzzle.”
Foss, too, wants to see broader awareness of Cannabis’s potential for specific communities, like veterans and women with autoimmune disorders. “There’s so much research that needs to be done, and Cannabis could be key.’”
Nursing the Future
Although “Cannabis Nursing: Scope and Standards of Practice” marks a significant milestone, both Foss and Dr. Sommers agree there is much more to accomplish. They encourage nurses, educators and policymakers to get involved, whether by joining the ACNA, advocating for policy updates or expanding research on medical Cannabis.
For nurses and nursing students, the bottom line is that health care is changing — and Cannabis nursing could be at the forefront of a more holistic, personalized approach. “We’ll be doing a fundraising drive specifically for the scope and standards in 2025,” Foss said. “That’ll keep us growing, building this community.”
Meanwhile, Dr. Sommers echoed that there is no better time than now to explore Cannabis nursing. “I want people to understand how big this is for nursing.”
